JACKSONVILLE, Fla. – A local family says an ongoing contract dispute between Baptist Health and Cigna could force them to find new doctors, travel hours for specialized pediatric care and potentially pay thousands of dollars out of pocket if a new agreement is not reached before June 23.
Amanda and Jason LaPointe are among thousands of Northeast Florida residents who could lose in-network access to Baptist Health facilities if negotiations between the health system and insurance provider Cigna fail.
Baptist Health said it is “at a critical point” in negotiations and is “very concerned that Cigna will force Baptist Health hospitals and providers out of network on June 23.”
“Cigna canceled their contract with Baptist Health hospitals. This is not what we want, and it is not our choice,” Baptist said in a statement. “Baptist Health does not want anyone to lose access to the care they need.”
The LaPointes said they recently received a letter from Baptist warning that their children’s specialized pediatric care could no longer be covered as in-network after June 23.
“It kind of makes me angry that it just seems like they’re both pointing fingers still,” Amanda LaPointe said after reading the letter.
The family’s oldest daughter has hip dysplasia and requires ongoing monitoring from specialists. Their younger daughter previously received speech therapy and underwent surgery through Baptist-affiliated providers.
Amanda LaPointe said the family has relied on the same pediatric practice since their oldest child was born seven years ago.
“They’ve always been great to us, so now to start over it’s kind of stressful,” she said.
The family said they are now trying to determine where to continue their daughters’ care, but options for pediatric specialty services in Jacksonville are limited.
“For major things like orthopedics, we’re going to have to go probably outside the city,” Jason LaPointe said. “The only game in town for that in Jacksonville was Wolfson’s and Nemours, and it’s all under the Baptist umbrella.”
The couple said future appointments may require trips to Orlando or Tampa.
The potential loss of access to Wolfson Children’s Hospital is one of the family’s biggest concerns. Baptist called Cigna’s decision to terminate its contract with Wolfson “particularly disappointing” because it could limit access to critical pediatric care in Northeast Florida.
“As the only dedicated children’s hospital here, we play an irreplaceable role in caring for kids,” Baptist said.
The LaPointes also worry about the financial impact of continuing care with their current providers if they become out of network.
When their daughter was referred for physical therapy earlier this year, Amanda LaPointe said Baptist Rehab told her out-of-pocket costs could exceed $3,000 per session.
“That’s just not affordable,” she said.
The dispute affects more than just the couple’s children.
Amanda LaPointe said she continues to receive care from multiple Baptist specialists after experiencing heart failure following the birth of one of her children.
“I have an army of doctors that literally saved my life when my daughter was born,” she said.
Baptist argues it has attempted to reach a compromise, saying it offered Cigna lower rates in hopes the insurer would pass savings on to members and employers. The health system also claims Cigna’s latest proposal would give the insurer greater control over some care decisions.
“We believe medical decisions should be made by trusted doctors who know their patients,” Baptist said.
The health system warned that if coverage is denied by an insurer, patients may be required to pay out of pocket for treatments or procedures.
For patients currently undergoing treatment, Baptist is encouraging them to apply immediately for continuity-of-care coverage through Cigna. The program may allow certain patients — including those with serious medical conditions, scheduled surgeries, chronic illnesses, high-risk pregnancies or terminal illnesses — to continue treatment with their current providers for a limited time. However, Baptist noted that Cigna determines eligibility, timelines and required documentation.
The health system also emphasized that emergency care at Baptist Health and Wolfson Children’s Hospital emergency departments will continue to be covered at in-network rates under federal law. CareSpot Urgent Care centers, Baptist Behavioral Health services and independent physician practices, including Nemours Children’s Health and many OB-GYN groups, are not affected by the dispute.
Still, the LaPointes say they remain frustrated by what they see as a breakdown in negotiations.
“I would probably say stop pointing fingers,” Jason LaPointe said. “Cigna demanding that Baptist lower their rates and Baptist stating that they’re lowering their rates and Cigna doesn’t want to negotiate or pay.”
Amanda LaPointe said the potential loss of access is especially concerning for families with children.
“They’re the biggest hospital for kids,” she said. “Anybody in Jacksonville that you ask where you would take your kids in case of an emergency, they would say Wolfson’s. They would say Nemours. So to take that away from such a large group of people, it just seems kind of selfish.”
Baptist said it remains willing to continue negotiations in the final days before the deadline if Cigna is willing to negotiate “in good faith.”
Unless a new agreement is reached, Cigna members will lose in-network access to Baptist Health hospitals and employed providers beginning June 23.
News4Jax has also reached out to Cigna for comment on this story. We are still waiting to hear back.